NIH Survey Shows Most People with Drug Use Disorders Never Get Treatment

Only 8 percent of people identified as drug abusers, and fewer than 40 percent of those diagnosed with drug dependence, have ever gotten any kind of intervention or treatment, according to the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The study was conducted by scientists from the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), components of the National Institutes of Health.

“Even though we know drug addiction treatment can work, lifetime treatment rates are substantially lower than corresponding treatment rates of other major psychiatric disorders,” says NIH Director Dr. Elias Zerhouni. “This tells us that we should focus on strategies designed to help us close the treatment gap."

“We are concerned because treatment rates are this low despite the availability of effective interventions,” says NIDA Director Dr. Nora D. Volkow. “We must encourage the public to view addiction as a brain disease that needs to be treated like any other chronic disease."

Says lead author Dr. Wilson Compton of NIDA, “Clearly, there is a need for increased information and outreach to destigmatize drug use disorders and develop approaches to educate physicians and the public about treatment.”

The survey results, published in the May 2007 issue of the Archives of General Psychiatry, show that rates of drug abuse and dependence are generally higher among certain populations, including men, respondents aged 18 to 44 years, and people who have never married. The study also confirmed that the onset of drug abuse and dependence typically occurs during late adolescence or early adulthood. These findings suggest that certain groups are more vulnerable and should be targeted for early intervention efforts.

“Our results indicate that in 2001-2002, two percent of American adults experienced drug abuse or dependence in the preceding 12 months, while ten percent developed a drug use disorder at some time during their lives,” says Dr. Compton. “We see high rates of drug use disorders in persons who are now 30 to 44 years old. This means we might expect increases in drug abuse and addiction rates of older adults as that group ages."

This study and others indicate that significant associations exist between drug abuse and co-occurring mental illness, including mood and anxiety disorders, and personality disorders. In fact, help-seeking behavior was more common in those with co-occurring psychiatric disorders. The authors advise that a person with a substance use disorder should also be evaluated for mental illness, and conversely, a person with a mental disorder should be evaluated for possible substance abuse.

The authors analyzed data gathered from face-to-face interviews with more than 43,000 U.S. adults age 18 and older, as part of the 2001-2002 NESARC. “The NESARC constitutes the largest study conducted on the co-occurrence of psychiatric disorders among U.S. adults,” said study co-author Dr. Bridget F. Grant, of NIAAA. “Because drug use disorders so commonly co-occur with alcohol use disorders, the NESARC provides rich information on the similarities and differences between these conditions.”

“The findings are consistent with the Annual National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA),” said SAMHSA Administrator Dr. Terry Cline. “The SAMHSA survey points to a huge denial gap. Among individuals with drug or alcohol dependence or abuse who have not received treatment, more than 94 percent do not feel they need treatment.”

In the NESARC survey, among those individuals with drug use disorders who received treatment, most went to physicians and other health care professionals, although many also used self-help groups. This finding underscores the continued importance of the detection and referral roles of primary care physicians. Future research efforts should focus on developing instruments to screen, identify, and refer patients with suspected drug abuse or dependence in primary care settings.

The study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) with supplemental support from the National Institute on Drug Abuse (NIDA).

The National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism are components of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at http://www.drugabuse.gov.

About the National Institutes of Health (NIH):
NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.